Application




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Membership Application
Please complete this form, then print it out and mail or fax it to the address below with a check payable to *IAICV* or with your credit card information.


	Company


	Address


	City/State/Zip


	Business Phone


	Business Fax


	Internet Address


	E-Mail Address


	Key Contact


	Alternate Contact


	Description of Business

	If your browser does not wrap text at the end of the line, press Shift+Enter to begin a new line.


	Number and Type of Vehicles


	How did you learn about the *IAICV*?


	Sponsor's Name


	Company

Please check one:
(See membership information for category descriptions)

	Jan-March Early Bird Submission	After April 1st Regular Dues Payment
Supplier Manufactures their own product or has produced private label product; sold directly to Vendors or Distributors; or through a Broker.	$ 800	$ 900
Broker Represents one or more Suppliers and sells product or services to the ice cream vending and distribution industry. (Never takes ownership of the product)	$ 600	$ 700
Distributor / Vendor Member Distributes Supplier and Broker product to other Vendors. (Houses product in a warehouse)	$ 600	$ 700
Vendor Leases a fleet of ice cream trucks; or sells to independent contractors or truck operators, but are not involved in distribution.	$ 450	$ 500
Associate Vendor Meets the definition of a Vendor Member; with less than 10 ice cream trucks, 20 pushcarts or 20 vending machines.	$ 300	$ 300

Annual membership dues are billed in January for calendar year.


	Signature


	Date

For Credit Cards Only:
American Express Visa Master Card

Card Number___________________________________
Expiration Date___________ (Mo/Yr)
Signature_________________________________
(Credit Card charges will appear as IAICV)

Print the completed application and mail or fax to:
IAICV
100 North 20th Street
4th Floor
Philadelphia, PA 19103-1443
Phone: (215) 564-3484
Fax (215) 564-2175
E-mail: iaicv@fernley.com

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